<script type="text/javascript">
window.addEvent('domready', function(){
new FormCheck('signup', {
		display : {
			errorsLocation : 1,
			showErrors : 1,
			addClassErrorToField : 1
		}
	})
})
</script>
<style type="text/css">
.uptitle{color:#555;}
.title {color: #666;}
</style>

<table width="400" border="0" cellspacing="5" cellpadding="5">
  
  <tr>
    <td align="left">
  <h2 class="uptitle">Sign Up</h2>
      <h3 class="uptitle">It's free and always will be</h3>  
    <hr color="#CCCCCC" size="1" width="100%" />
    <form action="<?php echo base_url()?>dashboard/newmember" method="post" enctype="multipart/form-data" name="signup" id="signup">
    <table cellspacing="2" cellpadding="3">
      <tr>
        <td align="right"><strong>
          <label for="first_name" class="title">First Name</span> :</label>
        </strong></td>
        <td>
          <input name="first_name" type="text" id="first_name" maxlength="25" class="validate['required']" />
        </td>
      </tr>
      <tr>
        <td align="right"><strong>
          <label for="last_name" class="title">Last Name :</label>
        </strong></td>
        <td>
          <input name="last_name" type="text" id="last_name" maxlength="25" class="validate['required']" />
        </td>
      </tr>
      <tr>
        <td align="right"><strong>
          <label for="email" class="title">Your Email :</label>
        </strong></td>
        <td>
          <input name="email" type="text" class="validate['required','email']" id="email" size="30" maxlength="100" />
        </td>
      </tr>
      <tr>
        <td align="right"><strong>
          <label for="confirm_email" class="title">Re-enter Email :</label>
        </strong></td>
        <td>
          <input name="confirm_email" type="text" class="validate['required','email','canfirm[email]']" id="confirm_email" size="30" maxlength="100" />
        </td>
      </tr>
      <tr>
        <td align="right"><strong>
          <label for="username" class="title">Username :</label>
        </strong></td>
        <td>
          <input name="username" type="text" id="username" maxlength="25" class="validate['required']" />
        </td>
      </tr>
      <tr>
        <td align="right"><strong>
          <label for="password" class="title">New Password :</label>
        </strong></td>
        <td>
          <input name="password" type="password" id="password" value="" maxlength="30" class="validate['required']" />
        </td>
      </tr>
      <tr>
        <td align="right" class="title"><strong>I am :</strong></td>
        <td>
          <select name="sex" id="sex" class="validate['required']">
            <option value="">Select Sex:</option>
            <option value="1">Female</option>
            <option value="2">Male</option>
          </select>
        </td>
      </tr>
      <tr>
        <td align="right" class="title"><strong>Birthday :</strong></td>
        <td>
          <select id="birthday_month" name="m" class="validate['required']">
            <option value="">Month:</option>
            <option value="1">Jan</option>
            <option value="2">Feb</option>
            <option value="3">Mar</option>
            <option value="4">Apr</option>
            <option value="5">May</option>
            <option value="6">Jun</option>
            <option value="7">Jul</option>
            <option value="8">Aug</option>
            <option value="9">Sep</option>
            <option value="10">Oct</option>
            <option value="11">Nov</option>
            <option value="12">Dec</option>
          </select>
          <select name="d" id="birthday_day" autocomplete="off" class="validate['required']">
            <option value="">Day:</option>
            <?php 
            for($i=1;$i<=31;$i++){
            	echo "<option value='$i'>$i</option>";
            }
            ?>
          </select>
          <select name="y" id="birthday_year" autocomplete="off" class="validate['required']">
            <option value="-1">Year:</option>
             <?php 
             $now = (date("Y")-10);
             $ago = $now-70;
            for($i=$now;$i>=$ago;$i--){
            	echo "<option value='$i'>$i</option>";
            }
            ?>
          </select>
        </td>
      </tr>
      
    </table>
    <hr color="#CCCCCC" size="1" width="100%" />
	<input style="width:120px;height:30px" class="uiButton uiSave" type="submit" name="submit" id="submit" value="Signup" />
  </form>
  </td>
  </tr>
</table><br />

